Evidence map›Paper›PMID 37172043›Full record

ArticlePloS one2023

Validation of the Nelwan Score as a screening tool for the diagnosis of typhoid fever in adults in Indonesia.

Erni Juwita Nelwan, Luh Putu Listya Paramita, Robert Sinto, Decy Subekti, Fransiscus Nikodemus Hosea, Pringgodigdo Nugroho, Herdiman T Pohan

Abstract read
In one paragraph

Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Erni Juwita NelwanDivision of Tropical and Infectious Disease, Department of Internal Medicine, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.ORCID 0000-0003-4064-5412
Luh Putu Listya ParamitaDepartment of Internal Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia.
Robert SintoDivision of Tropical and Infectious Disease, Department of Internal Medicine, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Decy SubektiOxford University Clinical Research Unit, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Fransiscus Nikodemus HoseaDepartment of Internal Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia.
Pringgodigdo NugrohoDivision of Nephrology and Hypertension, Department of Internal Medicine, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Herdiman T PohanDivision of Tropical and Infectious Disease, Department of Internal Medicine, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTyphoid fever diagnosis is challenging for clinicians in areas with limited laboratory facilities. Scoring methods based on signs and symptoms are useful for screening for probable cases of typhoid fever. The Nelwan Score variables are derived from the clinical signs and symptoms of patients with suspected typhoid. We validated the Nelwan Score compared to laboratory tests as the gold standard.

methodsThis cross-sectional study was conducted between July 2017 and January 2018 in five hospitals and two primary health care centers in Jakarta and Tangerang, Indonesia. Patients with fever for 3-14 days and gastrointestinal symptoms were evaluated using the Nelwan Score. Blood cultures, samples for polymerase chain reaction testing, and additional rectal swab cultures were collected simultaneously to confirm the diagnosis of typhoid. Data were analyzed using a contingency table to measure sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), and the optimal cut-off of the Nelwan Score for typhoid diagnosis was determined using a receiver-operating characteristic curve.

resultTyphoid was confirmed in 11 of the 233 patients (4.7%) with suspected typhoid. Among laboratory-confirmed typhoid cases, the median Nelwan Score was 11 (range: 9-13) and the optimal cut-off value was 10, with an area under the curve of 71.3%, sensitivity of 81.8%, specificity of 60.8%, PPV of 9.3%, and NPV of 98.5%.

conclusionA Nelwan Score of 10 is the best cut-off value for screening for typhoid fever. It is useful as screening tool for typhoid fever, where laboratory resources are limited, and could help to decrease irrational antibiotic use.

Indexed as

Typhoid FeverAdultCross-Sectional StudiesHumansIndonesiaSalmonella typhiSensitivity and Specificity

Identifiers

PMID37172043
PMCPMC10180627

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